For the last 2 weeks, have you had any of the following problems nearly every day?
 

1.  Trouble falling or staying asleep, or sleeping too much?        YES _______    NO______

2.  Feeling tired or having little energy?                                    YES _______    NO______
 
3.  Poor appetite or overeating?                                               YES _______    NO______

4.  Little interest or pleasure in doing things?                            YES _______    NO______

5.  Feeling down, depressed, or hopeless?                               YES _______    NO______

6.  Feeling bad about yourself -- or that you are a failure--
   or have let yourself or your family down?                               YES _______    NO______

7.  Trouble concentrating on things, such as reading the
 newspaper or watching television?                                          YES _______    NO______

8.  Being so fidgety or restless that you were moving around a
 a lot more than usual?  Or the opposite -- moving or
 speaking so slowly that other people could have noticed?         YES _______    NO______

9.  In the last 2 weeks have you had thoughts that you would
 be better off dead or of hurting yourself in some way?               YES _______    NO______

 Tell me about it.______________________________________________________________

____________________________________________________________________________

Are answers to five or more of # 1 to # 9 Yes?       YES _______    NO______